U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce
Insurance Services Programs
Appendix C
Qualifying Life Events (QLEs)
that May Permit a Change in Your FEHB Enrollment
(for Former Spouses under Spouse Equity provisions)
RI 70-05 For TCC and Former Spouse Enrollees
Qualifying Life Events are those events that permit individuals to change their health benefits enrollment outside of the annual Open Season period. Below is a brief list of the more common qualifying life events for Former Spouses under the Spouse Equity provisions. (Note: Former spouses may change to Self and Family only if family members are also eligible family members of the employee or annuitant.) Be aware that time limits apply for requesting changes. A complete listing of qualifying life events can be found at www.opm.gov/forms/pdf_fill/sf2809.pdf. For more details about these and other qualifying life events, contact the human resources office of your employing agency or retirement system.
| From Not Enrolled to Enrolled | From Self Only to Self and Family | From One Plan or Option to Another | |
|---|---|---|---|
| Change in family status based on addition of family members who are also eligible family members of the employee or annuitant. | No |
Yes |
Yes |
| Former spouse or eligible child loses FEHB coverage due to termination, cancellation, or change to Self Only of the covering enrollment. | Yes |
Yes |
Yes |
| On becoming eligible for Medicare. This change may be made only once in a lifetime.) | Not Applicable |
No |
Yes |
Enrolled former spouse or eligible child loses coverage under another group insurance plan, for example:
|
Not Applicable |
Yes |
Yes |
Qualifying Life Events (QLEs)
that May Permit a Change in Your FEHB Enrollment
(for Temporary Continuation of Coverage for Eligible Former Employees, Former Spouses, and Children)
Below is a brief list of the more common qualifying life events for Temporary Continuation of
Coverage (TCC) for Eligible Former Employees, Former Spouses, and Children. Be aware
that time limits apply for requesting changes. A complete listing of qualifying life events can be
found at www.opm.gov/forms/pdf_fill/sf2809.pdf. For more details about these and other
qualifying life events, contact the human resources office of your employing agency or retirement
system.
| From Not Enrolled to Enrolled | From Self Only to Self and Family | From One Plan or Option to Another | |
|---|---|---|---|
| Change in family status (except former spouse): for example, marriage, birth or death of family member, adoption, legal separation, or divorce | No |
Yes |
Yes |
| On becoming eligible for Medicare | Not Applicable |
No |
Yes |
| Change in family status of former spouse, based on addition of family members who are eligible family members of the employee or annuitant. | No |
Yes |
Yes |
U.S. Office of Personnel Management 1900 E Street NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532